Han Areum, Wilroy Jereme D, Jenkins Jeremy, Yuen Hon K
Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, USA.
Disabil Rehabil. 2023 Feb;45(4):644-654. doi: 10.1080/09638288.2022.2038283. Epub 2022 Feb 12.
This study examined effects of coach-guided videoconferencing acceptance and commitment therapy (ACT) accompanied by psychoeducation on distressed individuals with spinal cord injury (SCI) and explored participants' experiences in the intervention.
Ten people with SCI participated in 8 individual videoconferencing sessions delivered by trained coaches. Data using self-reported questionnaires and individual interviews was collected at pretest and posttest and analyzing using Wilcoxon signed-rank tests and interpretative phenomenological analysis (ClinicalTrials.gov ID: NCT04670406).
Statistically significant improvements were found in depression, anxiety, stress, grief, engagement in meaningful activities, and self-compassion with medium to large effect sizes. There was no significant change in quality of life, resilience, and ACT processes. Participants gained a new way of thinking by: being aware of thoughts and emotions; exploring perceptions of others; and focusing on the present. Also, the intervention equipped participants to deal with challenges by: improving coping with SCI-related conditions; practicing self-compassion, acceptance, and meditation; and acquiring skills of value-based decision making and committed action.
Findings contribute to the limited evidence as the first study that measured effects of videoconferencing ACT on people with SCI. Future randomized controlled trials are needed to measure efficacy of internet-delivered ACT for people with SCI.IMPLICATIONS FOR REHABILITATIONGuided videoconferencing ACT may reduce depressive symptoms, anxiety, stress, and grief and increase engagement in meaningful activities and self-compassion in people with SCI.Professionals may consider ACT as a supportive or adjunct service for people with SCI who experience psychological distress.
本研究考察了由教练指导的、伴有心理教育的视频会议接纳与承诺疗法（ACT）对脊髓损伤（SCI）痛苦个体的影响，并探讨了参与者在干预中的体验。
10名脊髓损伤患者参加了由训练有素的教练提供的8次个人视频会议课程。在预测试和后测试时收集使用自我报告问卷和个人访谈的数据，并使用威尔科克森符号秩检验和解释现象学分析进行分析（ClinicalTrials.gov标识符：NCT04670406）。
在抑郁、焦虑、压力、悲伤、参与有意义活动和自我同情方面发现了具有统计学意义的改善，效应量为中到大型。生活质量、恢复力和ACT过程没有显著变化。参与者通过以下方式获得了一种新的思维方式：意识到思想和情绪；探索对他人的看法；以及关注当下。此外，干预使参与者能够通过以下方式应对挑战：改善对脊髓损伤相关状况的应对；练习自我同情、接纳和冥想；以及获得基于价值观的决策和坚定行动的技能。
作为第一项测量视频会议ACT对脊髓损伤患者影响的研究，本研究结果为有限的证据做出了贡献。未来需要进行随机对照试验来测量互联网提供的ACT对脊髓损伤患者的疗效。
对康复的启示
指导性视频会议ACT可能会减轻脊髓损伤患者的抑郁症状、焦虑、压力和悲伤，并增加他们参与有意义活动和自我同情的程度。
专业人员可能会将ACT视为对经历心理困扰的脊髓损伤患者的一种支持性或辅助性服务。
